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Azoyan L, Lombardi Y, Renaud MC, Duguet A, Georgin-Lavialle S, Cohen-Aubart F, Ibanez G, Steichen O. [Association between students' clinical performance and their success in the computerized national ranking tests: A single-center retrospective cohort study]. Rev Med Interne 2023; 44:5-11. [PMID: 35934597 DOI: 10.1016/j.revmed.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/04/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Before attending residency, 6th-year French medical students must validate a final examination including a practical clinical test in their faculty. However, the national ranking that determines their future specialty and region solely relies on a computerized knowledge test. Our goal was to investigate the association between the final faculty test and the national ranking test. METHODS In our faculty, the final examination includes a computerized theoretical test (similar to the national one) and a practical test: a standardized evaluation of semiology skills at the bedside and a standardized assessment of relational skills with role plays. The agreements between the national test and faculty computerized and practical tests were analyzed by intraclass correlation coefficients (ICC). RESULTS Data from 1806 students who underwent the three examinations from 2017 to 2021 were analyzed. There was a good agreement between the ranks in the faculty and national computerized tests: ICC 0.83 (95% CI 0.81-0.85). By contrast, the agreement between the ranks in the faculty practical test and the national computerized test was poor: ICC 0.13 (95% CI 0.08-0.17). Results were stable over the years. CONCLUSION The agreement between the ranking of the current national test and the clinical skills assessed by a specific faculty test is poor. This could relate to a true independence or to different levels of motivation to perform well. Indeed, the result of the national test is the most important one as it determines their career. Incorporating a clinical assessment into the national ranking test will motivate students to acquire clinical skills and value those who perform well this practical dimension.
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Affiliation(s)
- L Azoyan
- AP-HP, Hôpital Tenon, service de médecine interne, 4 rue de la Chine, 75020 Paris, France; Sorbonne Université, faculté de médecine, Paris, France.
| | - Y Lombardi
- AP-HP, Hôpital Tenon, soins intensifs néphrologiques et rein aigu, 4 rue de la Chine, 75020 Paris, France; Sorbonne Université, faculté de médecine, Paris, France
| | - M C Renaud
- Sorbonne Université, faculté de médecine, Paris, France
| | - A Duguet
- Sorbonne Université, faculté de médecine, Paris, France
| | - S Georgin-Lavialle
- AP-HP, Hôpital Tenon, service de médecine interne, 4 rue de la Chine, 75020 Paris, France; Sorbonne Université, faculté de médecine, Paris, France
| | - F Cohen-Aubart
- Sorbonne Université, faculté de médecine, Paris, France; AP-HP, Hôpital de la Pitié-Salpêtrière service de médecine interne 2, 47-83 boulevard de l'Hôpital, 75013 Paris, France
| | - G Ibanez
- Sorbonne Université, faculté de médecine, Paris, France; Sorbonne Université, département de médecine générale, Paris, France
| | - O Steichen
- AP-HP, Hôpital Tenon, service de médecine interne, 4 rue de la Chine, 75020 Paris, France; Sorbonne Université, faculté de médecine, Paris, France; INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, équipe Sentinelles, 27 rue de Chaligny, 75012 Paris, France
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Bragin I, Cohen DT. Certified Examination Assistants in the Age of Telemedicine: A Blueprint Through Neurology. JMIR MEDICAL EDUCATION 2021; 7:e28335. [PMID: 34612828 PMCID: PMC8529478 DOI: 10.2196/28335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/26/2021] [Accepted: 08/31/2021] [Indexed: 06/13/2023]
Abstract
The optimal approach to a clinical physical examination via telemedicine is still being explored. The medical community has no standardized or widely followed criteria for telemedicine examinations, so a broad spectrum of approaches is used. Unfortunately, the need for telemedicine is outpacing physical examination validation research. Given that certain specialties have been using telemedicine longer than others, lessons from those specialties might aid in developing standardized protocols for telemedicine. Neurology has been at the forefront of telemedicine use, initially through stroke care and later in multiple subspecialties. We present a framework for optimizing the history taking and physical examination process via telemedicine based on our experience in neurology. This mainly includes remotely examining a patient unassisted or with an untrained assistant present on the patient side of the connection. We also discuss the need for trained, certified assistants to assist the off-site physician in history taking and physical examination. These certified assistants would be allied health professionals who perform high-quality cued patient examinations under direct physician supervision with no responsibility to diagnose or treat. This contrasts with the approach seen in advanced practice providers such as physician assistants and nurse practitioners who undergo years of training to diagnose and treat patients under supervision. This training process would serve as a stepping stone for the development of dedicated certification programs for neurology and other medical specialties; however, assessments of practical training, costs, implementation, and longitudinal quality are warranted.
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Affiliation(s)
- Ilya Bragin
- St. Luke's University Health Network, Bethlehem, PA, United States
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States
| | - Dylan T Cohen
- St. Luke's University Health Network, Bethlehem, PA, United States
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States
- SUNY Downstate Medical Center, Brooklyn, NY, United States
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Da J, Ran Y, Pi M, Wu J, Dong R, Li Q, Zhang Q, Zhang X, Zha Y. Application of mini-clinical evaluation exercise for assessing the integrated-based learning during physical diagnostic course. BIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION : A BIMONTHLY PUBLICATION OF THE INTERNATIONAL UNION OF BIOCHEMISTRY AND MOLECULAR BIOLOGY 2018; 46:417-423. [PMID: 30242954 DOI: 10.1002/bmb.21137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 05/06/2018] [Accepted: 06/05/2018] [Indexed: 06/08/2023]
Abstract
Medical education paradigm has been questioned for the requirements of improving the quality and quantity of medical students. This study was to explore the efficiency of integrated-based learning (IBL) used mini-clinical evaluation exercise (mini-CEX) during physical diagnostics course. One hundred and eleven volunteered students were randomly divided into three groups: lecture-based learning (LBL), case-based learning (CBL), and IBL. Nephrotic syndrome was the teaching content. In the IBL group, students were provided the guideline and additional interpretation from the instructor about the basic knowledge related to disease as vertical integration curriculum. Their performance was evaluated by mini-CEX and theoretical examination, respectively. All subjects have completed the study. The difference of five factors (medical interview, physical examination, clinical judgment, organizational effectiveness, and competence) in mini-CEX between IBL, CBL, and LBL were statistically significant (p <0.05). Sample sizes of below, meets, and above the expectations of mini-CEX in different instructional groups were statistically significant (X2 =17.842, p =0.001). The final exam scores in IBL group and the CBL group were significantly higher than that of LBL group (F =41.553, p =0.000). And the relationship of final exam score only in the IBL group was positive existed with medical interview (R =0.466, p =0.004), physical examination (R =0.328, p =0.048), professional attitude (R =0.366, p =0.026), and communication skill (R =0.412, p =0.011). Therefore, our study revealed the effect of IBL on the medical students' skills. It highlights IBL could improve the physical examination, organizational effectiveness, and competence and the application of basic knowledge. © 2018 International Union of Biochemistry and Molecular Biology, 46(5):417-423, 2018.
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Affiliation(s)
- Jingjing Da
- Renal Division, Department of Medicine, People's Hospital of Guizhou Province,Guiyang, Guizhou, 55002, China
- Department of Diagnostics, Medical College of Guizhou University, Guiyang, Guizhou, 550002, China
| | - Yan Ran
- Renal Division, Department of Medicine, People's Hospital of Guizhou Province,Guiyang, Guizhou, 55002, China
- Department of Diagnostics, Medical College of Guizhou University, Guiyang, Guizhou, 550002, China
| | - Mingjing Pi
- Renal Division, Department of Medicine, People's Hospital of Guizhou Province,Guiyang, Guizhou, 55002, China
- Department of Diagnostics, Medical College of Guizhou University, Guiyang, Guizhou, 550002, China
| | - Jing Wu
- Renal Division, Department of Medicine, People's Hospital of Guizhou Province,Guiyang, Guizhou, 55002, China
- Department of Diagnostics, Medical College of Guizhou University, Guiyang, Guizhou, 550002, China
| | - Rong Dong
- Renal Division, Department of Medicine, People's Hospital of Guizhou Province,Guiyang, Guizhou, 55002, China
- Department of Diagnostics, Medical College of Guizhou University, Guiyang, Guizhou, 550002, China
| | - Qian Li
- Renal Division, Department of Medicine, People's Hospital of Guizhou Province,Guiyang, Guizhou, 55002, China
- Department of Diagnostics, Medical College of Guizhou University, Guiyang, Guizhou, 550002, China
| | - Qian Zhang
- Medical College of Guizhou University, Guiyang, Guizhou, 550002, China
| | - Xiangyan Zhang
- Department of Clinical Education, People's Hospital of Guizhou Province, Guiyang, Guizhou, 550002, China
- Medical College of Guizhou University, Guiyang, Guizhou, 550002, China
| | - Yan Zha
- Renal Division, Department of Medicine, People's Hospital of Guizhou Province,Guiyang, Guizhou, 55002, China
- Department of Diagnostics, Medical College of Guizhou University, Guiyang, Guizhou, 550002, China
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Alamri MS, Almazan JU. Barriers of physical assessment skills among nursing students in Arab Peninsula. Int J Health Sci (Qassim) 2018; 12:58-66. [PMID: 29896073 PMCID: PMC5969778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE There is a growing demand for health-care nursing services in several health care institutions. Understanding barriers to physical assessment among nursing students create a more detailed assessment in the development of quality patient's care in nursing practice. This study examined the barriers to physical assessment skills among nursing students in a government university in Arab Peninsula. METHODS A cross-sectional research survey design of 206 nursing students using a standardized questionnaire was used. The questionnaire is composed of 7 subscales in evaluating the barriers to physical assessment skills between the classroom and clinical setting. Independent Samples t-test was used in comparing the gender mean of the nursing students about the barriers to physical assessment. Paired t-test was also used in determining the differences between perceived barriers to physical assessment in the classroom and clinical setting. RESULTS Subscale "reliance on others and technology," ward culture, "lack of influence on patient care" have significant differences between perceived barriers in physical assessment among classroom settings and clinical setting. CONCLUSION Although nursing students were oriented and educated about physical assessment in the nursing curriculum, this is not often practiced in clinical settings. The point that is if nursing students are incorrectly performing the patient assessment, then no amount of critical thinking could lead to better clinical decisions. Continuous exposure and enhancing the quality of planning and promotion of the nursing students could develop necessary skills. In addition, increasing self-confidence is vital to assess the patient's health status effectively and minimize the barriers to performing the physical assessment.
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Affiliation(s)
- Majed Sulaiman Alamri
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Joseph U. Almazan
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia,Address for correspondence: Joseph U. Almazan, Department of Nursing, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia. Phone: +966583884029. E-mail:
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